Oh, Mom! Older parent’s desire to age in place tests family

“Mom!” I overhear DC saying to his mother, whose hand is in the nut bowl. “You can’t eat nuts. You don’t have your teeth in!”

Oh, Mom. It’s a refrain we’re uttering often lately, part in head-shaking humor, part in grave concern.

My mother-in-law, who is 86, was living with us until last week. DC had brought her down from Pittsburgh for a yearlong month to size her up and figure out what kind of help she needed. He’d noticed changes. She’d been forgetting to pay bills, had lost weight she couldn’t afford, and had trouble finding words.

At our home, she donned strange outfits: tank tops over sweatshirts over nightgowns, with a towel cape. She said odd things: How long have you lived with the Amish? And she put her dirty clothes in the dishwasher.

One day, early in her visit while DC and I were at work, she wandered from the house, ended up down the street at the neighbors’. They didn’t know where she belonged, so called the police, who called DC at work.

“What were you doing?” he asked when he retrieved her. “Going home.” “It’s a mighty long walk from Orlando to Pittsburgh.” “I want to go home.” “We’re trying to help you.” Oh, Mom. We hired a home health professional to stay with Mom on weekdays. The kind, patient woman helped Mom get dressed, made her lunch, kept her company and took her on outings.

Well, one outing. At the park, Mom yelled to passers-by that she was being held prisoner and tried to run away.

Here we thought figuring out what kind of help Mom needed would be the hard part. But far harder was getting Mom to agree. She does not want help. She does not want companion care. She does not want to be at our house. And above all, she does not want to be “sent away.” She just wants to go home, to the house she has lived in for 45 years.

Home. That powerful word, that place that holds us with the magnetic pull of the earth. I respect every person’s right to be there for as long as they can.

But how long that is, who’s to say? I’m not an ethicist, or moralist, or philosopher, but I can tell you: This area is so gray it’s black.

I have ridden through these rough waters with my parents, and now I’m watching, somewhat mutely, as DC and his sister, like millions of adult children past, present and future, stand at a crossroads, stalled at the intersection of freedom and safety, facing that Sophie’s Choice: to override or honor a parent’s wish to stay independent.

Last week, Mom went home to Pittsburgh, where DC and his sister, who lives there, cobbled together a plan: His sister and her three grown sons would stop in often, and a home care companion would visit daily for several hours.

That lasted one day, then Mom locked the door and refused to let the companion in. That was that. Oh, Mom. Now comes the part where I am supposed to have an easy cookie-cutter answer. I do not. However, I did glean these bits of wisdom from the National Association of Senior Move Managers, an organization whose professionals encounter all brands of resistance from seniors in transition.

•Size them up. When deciding whether a loved one needs help at home and how much, use the following sliding scale, said MaryKay Buysse, executive director:

Emergencies. How well could they handle an emergency? Could they get out the door on their own, or do they need assistance?

Physical ability. How much help do they need doing activities of daily living, getting up, bathing, dressing and fixing meals?

Socialization. How often in the last six months has the person gotten out to, say, church, shopping, or lunch with a friend? Isolation is one of the biggest reasons seniors need a change.

Mental ability. How clear is their thinking? Are they oriented in time and have little to no memory impairment, or are they disoriented, confused and forgetful?

•Get an expert opinion. Geriatric care managers or gerontologists are trained to assess the elderly, and can offer good objective advice and resources. You can find services and support from the Aging Life Care Association, www.aginglifecare.org.

•Get ahead of disaster. Ideally, Buysse said, she likes families to work actively to keep elders safe, “but the reality is, 99 percent wait for a crisis.”

•Modify the home. Help the senior age in place by modifying the home to make it safer: put grab bars in bathrooms, plug in nightlights, remove trip hazards such as area rugs and clutter, add deadbolts to doors leading to stairways, install lever handles in place of door knobs, and, if necessary, remove knobs from the stove, said Katie Hustead, NASMM president elect and owner of Paper Moon Moves, in Brooklyn.

•Show them the options. “Elderly clients often resist moving into independent or assisted living centers because they think they’re going the ‘The Home,’ which they think is this awful place. Then they visit, have lunch, and see how nice it can be,” Hustead said.

•Respect their wishes. Let the senior have as much control as possible. “Even if they have dementia, try not to make them feel forced into something,” Hustead said. Easier said than done.